Testimony to the Oregon House of Representatives by Anthony Aldeguer, from May 25, 2010

Madam Chair and Fellow Committee Members,

I am honored to be granted this privilege to speak before you. I am a patient at Oregon State Hospital. I come before you to speak on behalf of myself, my peers and more importantly to give voice to those peers whose voices are not being heard as many of them are fearful of retaliation and/or unable to advocate for themselves.

The need for quality care, treatment and rehabilitation at Oregon State Hospital will be the focus of my testimony.

For many years Oregon State Hospital has been lobbying for additional funding to improve patient care. There is a proven track record that even after having received additional funding, the overall hospital culture has not changed. Improvements in the quality of patients’ care have little to do with money. Instead, it has everything to do with humane treatment of us patients such as compassion, empathy and empowerment so we can become active participants in our recovery.

One contributing factor that affects the quality of patient health care at Oregon State Hospital is related to chronic under-staffing and mandated overtime.

Staff are mandated to work numerous overtimes which has an adverse effect on their mental and physical well-being.

Specifically, it affects staff’s morale and their alertness when attending to patients’ care and needs.
Therefore, an immediate intervention to improve the inadequate staffing situation at the hospital is imperative.

From my own personal experience I can say that the therapeutic treatment milieu differs significantly from one forensic ward to another. The staff on one ward may be dedicated to creating a healthy milieu, while on another ward staff may operate on the premise that patients need to be controlled.

We believe that organizational change needs to happen on all levels. Ward staff need to be held accountable for their actions, otherwise the maladaptive patterns will be repeated over and over again. Furthermore, any newly hired staff will adapt to this dysfunctional culture.

An increase in staffing, new committees and an electronic record system do not change the culture of the hospital. Staff attitudes cannot be changed through that.

We support the Oregon State Hospital Advisory Board that was created by the Legislature in 2009 to improve the safety, security and care of patients at Oregon State Hospital. Without the Advisory Board’s and the United States Department of Justice’s ongoing review of the hospital operations, there will be a continuation of dysfunctional leadership.

It takes commitment, leadership and a hospital vision to change a culture. The primary goal of treatment should not be to control the patient’s behavior. Instead, the goal of patient treatment needs to move into the direction of assisting us to gain greater control of our lives.

In addition, we think that the current practices of the Psychiatric Security Review Board need to be addressed.

For example, when we ask at our hearing what we need to do to be granted a community placement evaluation; board members respond by saying:

“If you do ‘A, B, C’, we will grant you the community placement evaluation upon your return to see us.” However, when we return, we are told: “We see that you fulfilled what we asked of you nine months ago, yet before we grant you the placement evaluation, we also want you to do ‘X, Y, Z’.”

Consequently, we are held in the hospital longer than necessary. This practice of the Psychiatric Security Review Board undermines the morale of patients; it leads to losing hope and ultimately to stagnation in our recovery process.

My peers and I sincerely thank you for allowing me to bring these issues to your attention today.

Thank you very much for your time.

Anthony Aldeguer has been a Oregon State Hospital patient for 2 1/2 years.

READ – Hearing, new numbers suggest problems are far from solved at the Oregon State Hospital, The Oregonian, May 26 2010